Different Types of Social Security Disability

As an attorney specializing in Social Security benefits, one of the most common areas of confusion for my clients is the difference between disability benefits under Title II and Title XVI of the Social Security Act. While both programs are administered by the Social Security Administration (SSA) and use the same medical definition of disability for adults, their eligibility requirements and funding sources are distinct. Understanding these differences is crucial when you're seeking the benefits you deserve. Let's break down Title II and Title XVI, commonly known as SSDI and SSI.

Title II: Social Security Disability Insurance (SSDI) What it is:

Title II of the Social Security Act establishes the Social Security Disability Insurance (SSDI) program. Think of SSDI as an insurance program that you've paid into through your payroll taxes (FICA contributions) during your working years. Just like car insurance or health insurance, your eligibility for SSDI is based on your past contributions.

Who is eligible?

To be eligible for SSDI, you generally need to meet two main criteria:

(1) Work Credits (Insured Status): You must have worked long enough and recently enough in jobs covered by Social Security to earn enough "work credits." The number of credits required varies depending on your age when your disability began. For most adults, this means earning 40 credits, with 20 of those earned in the last 10 years before your disability onset. (Important Note: There are exceptions for younger workers who may not have had the opportunity to accrue as many credits.)

(2) Medical Disability: You must meet the SSA's strict definition of disability. This means you have a medically determinable physical or mental impairment (or a combination of impairments) that:

  • Has lasted or is expected to last for a continuous period of at least 12 months, OR is expected to result in death.
  • Your condition must be severe enough to prevent you from engaging in "substantial gainful activity" (SGA). The SGA amount changes annually, but it's essentially an earnings limit that the SSA uses to determine if you're able to work.

Key Characteristics of SSDI Program:

  • Funded by: Payroll taxes (Social Security trust fund).
  • Not Needs-Based: Your income and resources (assets) after you become disabled generally do not affect your eligibility or benefit amount.
  • Potential for Family Benefits: Your spouse and dependent children may also be eligible for benefits based on your work record.
  • Medicare Eligibility: After receiving SSDI benefits for 24 months, you typically become eligible for Medicare.
  • Waiting Period: There is generally a five-month waiting period from the date your disability began before you can receive your first benefit payment.

Title XVI: Supplemental Security Income (SSI) What it is:

Title XVI of the Social Security Act establishes the Supplemental Security Income (SSI) program. Unlike SSDI, SSI is a financial needs-based program designed to provide financial assistance to aged, blind, and disabled individuals who have limited income and resources, regardless of their work history.

Who is eligible?

Eligibility for SSI hinges on three primary factors:

(1) Medical Disability (or Age/Blindness): You must be:

  • Medically disabled (meeting the same medical definition as for SSDI for adults); or
  • Blind (meeting the SSA's definition of blindness); or
  • Age 65 or older; or
  • For Children: Children under 18 can also qualify for SSI if they have a medically determinable physical or mental impairment that causes marked and severe functional limitations, and that is expected to result in death or has lasted or can be expected to last for at least 12 months.

(2)Limited Income/Resources:

  • Your countable income must be below a certain threshold. Not all income is counted dollar-for-dollar; the SSA has specific rules and exclusions for different types of income (e.g., earned income is treated more favorably than unearned income).
  • Your countable resources (assets) must be below a certain limit. For an individual, this limit is typically $2,000, and for a couple, it's $3,000. Certain assets, like your home and one vehicle, are generally excluded.

Key Characteristics of SSI:

  • Funded by: General tax revenues (not Social Security payroll taxes).
  • Needs-Based: Eligibility and benefit amounts are directly impacted by your income and resources.
  • No Work Credit Requirement: You can be eligible for SSI even if you've never worked or haven't worked enough to earn SSDI work credits.
  • Medicaid Eligibility: In most states, receiving SSI benefits automatically qualifies you for Medicaid, providing crucial health insurance coverage.
  • No Waiting Period: SSI benefits can begin in the first full month after you apply and meet all eligibility criteria.

Can You Receive Both? (Concurrent Benefits)

Yes! It is possible to qualify for both SSDI and SSI, a situation known as "concurrent benefits." This often occurs when an individual's SSDI benefit amount is very low, perhaps due to a limited work history, and they also meet the strict income and resource limits for SSI. In such cases, SSI can supplement the SSDI benefit to bring the total up to the SSI Federal Benefit Rate, plus any state supplement.

Which One Should You Apply For?

If you believe you are disabled, an application for one is often an application for both if there's any chance you might meet the criteria for both programs. The SSA will evaluate your eligibility for both Title II and Title XVI benefits based on the information you provide.

Navigating the Social Security disability application process can be complex. Understanding the nuances between SSDI and SSI is a critical first step. If you're considering applying for disability benefits, or if your application has been denied, don't hesitate to seek legal guidance. An experienced Social Security disability attorney can help you determine which program(s) you're eligible for, gather the necessary documentation, and represent you throughout the application and appeals process.

This blog post is for informational purposes only and does not constitute legal advice. For personalized advice regarding your specific situation, please consult with a qualified attorney at Syfrett, Dykes & Furr.